A kórházban kezelt sebészeti és belgyógyászati betegekben jelentős a vénásthromboembolia-rizikó. Profilaxis nélkül, a műtét típusától függően, a sebészeti beavatkozások kapcsán a betegek 15–60%-ában alakul ki mélyvénás trombózis vagy tüdőembólia, és az utóbbi ma is vezető kórházi halálok. Bár a vénás thromboemboliát leggyakrabban a közelmúltban végzett műtéttel vagy traumával hozzák kapcsolatba, a szimptómás thromboemboliás események 50–70%-a és a fatális tüdőembóliák 70–80%-a nem a sebészeti betegekben alakul ki. Nemzetközi és hazai felmérések alapján a nagy kockázattal rendelkező sebészeti betegek többsége megkapja a szükséges trombózisprofilaxist. Azonban profilaxis nélkül marad a rizikóval rendelkező belgyógyászati betegek jelentős része, a konszenzuson alapuló nemzetközi és hazai irányelvi ajánlások ellenére. A belgyógyászati betegek körében növelni kell a profilaxisban részesülők arányát és el kell érni, hogy trombózisrizikó esetén a betegek megkapják a hatásos megelőzést. A beteg trombóziskockázatának felmérése fontos eszköze a vénás thromboembolia által veszélyeztetett betegek felderítésének, megkönnyíti a döntést a profilaxis elrendeléséről és javítja az irányelvi ajánlások betartását. A trombózisveszély megállapításakor, ha nem ellenjavallt, profilaxist kell alkalmazni. „A thromboemboliák kockázatának csökkentése és kezelése” című, 4. magyar antithromboticus irányelv felhívja a figyelmet a vénástrombózis-rizikó felmérésének szükségességére, és elsőként tartalmazza a kórházban fekvő belgyógyászati és sebészeti betegek kockázati kérdőívét. Ismertetjük a kockázatbecslő kérdőíveket és áttekintjük a kérdőívekben szereplő rizikófaktorokra vonatkozó bizonyítékokon alapuló adatokat.
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